The invention relates to endotracheal tubes, and more particularly to fiber optic illumination and viewing of the distal end of the endotracheal tube. The invention also relates to an auxiliary tube slidably disposed in the endotracheal tube for occluding one main stem bronchus while permitting ventilation of a lung through the other.
FIG. 1 shows a conventional endotracheal tube 10. It includes a connector 12 by means of which endotracheal tube 10 is connected to a conventional ventilator to assist a patient's breathing function. Endotracheal tube 10 also includes an inflatable balloon 14 on its distal end. Inflatable balloon 14 is inflated by means of a tube 16 which is connected by means of a end connector 18 to a small syringe-like air pump after the endotracheal tube 10 has been inserted into the patient's trachea 20, as shown in FIG. 2. In FIG. 2, balloon 14 is shown inflated, so that it occludes passage of air between the outer surface of endotracheal tube 10 and the inner surface of trachea 20. The ventilator can then efficiently pump air into and out of the patient's lungs.
Prior endotracheal tubes do not permit any visualization of what is going on in the patient's tracheal and bronchial passages. If such visualization is needed, the connector 12 (FIG. 1) is disconnected from the ventilator, and a conventional bronchoscope is inserted down the hollow passage 22 of endotracheal tube 2, allowing the physician to determine if a lot of mucous is present in either lung or in either of the left or right main stem bronchi 20A and 20B. If it is necessary to suction mucous out of either of the patient's lungs, a suctioning tube is inserted down the hollow passage 22 of endotracheal tube 10. The endotracheal tube may have to be disconnected from the ventilator to allow visualization in the trachea 20 of the lungs or to allow suctioning of mucous, blood, etc., if the endotracheal tube does not have a sealable side port through which the suctioning tube can be inserted.
A skilled physician, often a pulmonologist, inserts an endotracheal tube into a patient. It would be desirable for a nurse to be able to easily monitor the position of an endotracheal tube in a patient's trachea to determine if its location has been shifted so the nurse knows whether to call a physician for repositioning of it. It is also desirable to be able to determine accurately the position of an endotracheal tube without requiring an x-ray.
It should also be noted that prior bronchoscopes are complex, expensive instruments, typically costing $3,000 to $6,000.